Neoplastic encephalopathy: dynamic CT of cerebral gliomata

Intravenous contrast enhanced dynamic computed tomography of cerebral gliomata reveals a spectrum of patterns which reflect different degrees of neovascularity as well as a variable breakdown in the blood-tumor-barrier both intratumorally as well as between individual tumors. Phenomena not generally associated with gliomas including intrinsic neoplastic and peripheral cerebral hypoperfusion, hyperperfusion, and indications of vascular stealing are also demonstrated with this technique which conceivably explain and are partially responsible for certain aspects of the encephalopathy accompanying cerebral neoplasia. A comparison of the dynamic sequences with conventional selective cerebral angiography further indicates that the more contrast-sensitive dynamic method is potentially superior in the detection of subtle neovascularity.